Diana Cassady’s research while affiliated with University of California, Davis and other places

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Publications (84)


Figure 11. Scenario 2 (Amended Language) Expenditure Impacts by Category Postmandate, SB 172 
Insurance Coverage for Fertility Preservation: SB 172
  • Research
  • File available

May 2017

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328 Reads

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Sara Yoeun

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Diana Cassady

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[...]

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Non-partisan analysis of the medical effectiveness, cost and utilization, and public health impacts of proposed health insurance coverage for fertility preservation in California.

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Figure 1. Plan/Insurer Use of Oncology Clinical Pathways: Health Outcomes Summary
Figure 2. Plan/Insurer Use of Oncology Clinical Pathways: Cost Summary
California Health Benefits Review Programs Analysis of California Assembly Bill 1107 Oncology Clinical Pathway Act of 2017

The version of California Assembly Bill (AB) 1107 analyzed by CHBRP would require a health plan or insurer that develops and implements a clinical pathway for cancer treatment, as defined, to comply with certain requirements. In addition, the bill would prohibit a plan/insurer from developing and implementing an oncology clinical pathway (OCP) that discourages patient access to clinical trials, requires provider use of the pathway or adherence to specific treatments therein, or interferes with the independent clinical judgement of a provider in patient care. 1. Background. Cancer is the second leading cause of death (after heart disease) in the U.S., with treatment costs of $87.7 billion in 2014. An estimated 1.7 million individuals were expected to be diagnosed with cancer nationally in 2016, with 596,000 expected deaths. In California, about 173,000 new cases and 59,000 deaths were expected. To more effectively treat patients with cancer, many health plans/insurers and providers have begun to use oncology clinical pathways or OCPs. These have been defined by the American Society of Clinical Oncology (ASCO) as "detailed, evidence-based treatment protocols for delivering quality cancer care for specific patient populations, including the type and stage of disease," that "balance the considerations of clinical efficacy, safety, toxicities, cost, and scientific advances." 2. Use of OCPs. ASCO estimates that 60 health plans/insurers in the U.S. currently use OCPs, covering more than 170 million individuals. OCPs can be used for a variety of purposes in ways that are more flexible or more restrictive depending on implementation. CHBRP is aware of their use in educating providers and in offering financial incentives to providers for adherence to the recommended treatment sequence. Plans/insurers or providers can develop and implement their own OCPs, or purchase them from an external vendor. In 2016, several oncology pathway companies and at least one specialty benefits management organization were marketing OCPs to plans/insurers and providers for use in patient care. 3. Approach. AB 1107 does not mandate benefits for OCPs; rather, it establishes requirements for health plans/insurers who choose to develop and implement OCPs. There is no known evidence on outcomes, utilization, or costs associated with OCPs compliant with AB 1107 versus noncompliant OCPs; thus, CHRBP cannot conduct an evidence-based analysis on how health outcomes, utilization, or costs would be impacted by AB 1107. There is, however, some literature on plan/insurer and provider use of OCPs more generally. Although the focus of AB 1107 is health plans/insurers, the literature describing their use of OCPs is extremely limited (four studies). Thus, CHBRP also reviewed provider use of OCPs and identified 12 additional studies. 4. Medical effectiveness. CHBRP did not identify any studies of health plan/insurer use of OCPs that reported morbidity or mortality. However, CHBRP identified two studies examining the effects on emergency department (ED) and/or hospital use, which can be considered indicators of morbidity. These studies found that plan/insurer use of OCPs was associated with reductions in ED and hospital use, but CHBRP concluded that the evidence about effects on these outcomes is inconclusive because only one of these studies included a comparison group. In assessing the evidence on medical effectiveness for provider use of OCPs, CHBRP reviewed seven studies in the U.S., including one systemic review of 10 studies, but most did not have a comparison group. Therefore, it is uncertain whether changes in health outcomes could be attributed to provider use of OCPs. CHBRP concludes that there is limited evidence that provider use of OCPs improves some health outcomes, such as hospital length of stay, and does not decrease overall survival rates relative to usual care. 5. Cost. CHBRP identified and reviewed four studies of health plan/insurer use of OCPs that reported cost impacts. Due to weak study designs, however, CHBRP cannot conclude whether the costs reported in these studies were related to plan/insurer use of OCPs or other factors including baseline severity of disease. CHBRP concludes that there is insufficient evidence to assess the extent to which plan/insurer use of OCPs impacts costs. CHBRP reviewed three more recent studies of provider use of OCPs but, due to weak study designs, cannot conclude whether the lower reported costs were related to the use of OCPs or other factors including baseline severity of disease.





Citations (37)


... Recent analyses have identified significant state-wide disparities in "Purchase of Service" (POS) expenditures from California's Department of Developmental Services (DDS). Analyses of DDS Purchase of Service administrative data reveal disparities in service use and expenditures for schoolage youth (ages 7 to 16) and for people who are racial/ ethnic minorities (Harrington & Kang, 2016;Leigh et al., 2016). Specifically, Latino people had the lowest annual service expenditures across diagnosis and age groups compared to other racial and ethnic groups (Leigh et al., 2016). ...

Reference:

Community-Led Adaptations of a Promotora-Delivered Intervention for Latino Families of Youth with Developmental Disabilities
Spending by California's Department of Developmental Services for Persons with Autism across Demographic and Expenditure Categories

... In an exploratory analysis, we also aimed to assess whether social norms and attitudes changed following election-related media campaigns and implementation of SSB taxes in Oakland and San Francisco, CA relative to nearby comparison cities (Berkeley, which had a pre-existing SSB tax, and Richmond, which had no SSB tax). Considering that lower-income populations experience frequently targeted marketing of SSBs and have a greater burden of dietrelated disease, the current study focuses on populations living in lower-income neighborhoods [18][19][20]. ...

Disparities in Obesity-Related Outdoor Advertising by Neighborhood Income and Race
  • Citing Article
  • September 2015

Journal of Urban Health

... suggesting that students with low nutritional knowledge were 3.0 times more likely to have excess body fat compared to those with high nutritional knowledge. Nutritional knowledge forms the foundation of understanding food and its nutritional content, guiding informed food choices based on quality and quantity [28,29]. Individuals with high nutritional knowledge tend to have better nutritional status [29,30]. ...

The Effects of Nutrition Knowledge on Food Label Use: A Review of the Literature

Appetite

... Women expressed di culty in distinguishing between trustworthy and misleading online content, emphasising the need for enhanced digital literacy. These ndings resonate with prior research, indicating challenges in comprehending numerical data (33) and evaluating nutritional content (34). While there has been positive acceptability and engagement with the use of preconception digital interventions (35), our study suggests that women need to be empowered with practical skills as well as ability to critically assess information encountered online. ...

Misunderstanding of Front-Of-Package Nutrition Information on US Food Products

... Organizational health literacy focuses on the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others (HSS, 2021). At the individual level, adequate health literacy skills play a pivotal role in preventing and managing chronic diseases and other health concerns (Miller et al., 2015). Conversely, limited health literacy has been linked to unhealthy lifestyles, including smoking, poor diet, and lack of physical activity, all of which increase the risk of mortality and premature death (Mayberry et al., 2018;Wolf et al., 2007). ...

Relationships among Food Label Use, Motivation, and Dietary Quality

... To address the limitations of standardized tutorials, a variety of approaches to research ethics training have been developed across different research contexts. For example, Jetter et al. [20] supplemented a self-administered research ethics course designed for university researchers with a two-part "round table seminar" to discuss the content of the Belmont report and highlight issues of particular relevance to American Indian/Alaskan Native communities. Yonas et al. [12] created flexible research ethics training resources for academic and community partners that can be delivered in-person or online and have been deployed in a wide variety of CBPR contexts in the US. ...

Building Research Capacity With Members of Underserved American Indian/Alaskan Native Communities

Health Promotion Practice

... For example, Specht and Szot 9 tested six GPS receivers and found that logging receivers, such as Garmin Forerunner 310XT, demonstrated the highest accuracy in determining positions. In another similar research, four wearable GPS monitors were compared while four adults walked a distance of 1.24 km and the most accurate device was Garmin Forerunner 205. 10 Using a similar methodological approach, Lee et al. 11 chose four low cost GPS minotors and found that all devices were valid for distance estimation, with Garmin 60 to be the most accurate. ...

Use of Portable Global Positioning System (GPS) Devices in Exposure Analysis for Time-location Measurement
  • Citing Article
  • December 2009

Korean Journal of Environmental Health Sciences

... 2 In response, some landlords have established smokefree policies for their housing units, and some cities have established such policies for all multi-unit housing within their jurisdictions. 3 The military is in effect the largest landlord in the U.S., with control over approximately 630,000 units of housing, including about 134,000 family units, and barracks space (for single enlisted personnel) for 500,000, with locations in all 50 states, as well as in numerous countries around the world. Military personnel who live in such housing frequently have little or no control over whether to stay there. ...

Navigating Local Smoke-Free Multi-Unit Housing Policy Adoption
  • Citing Article
  • March 2013

Journal of Drug Education

... The themes identified in this case study are consistent with previous research on local, state, and national tobacco control policies that found that, among others, policy champions or change agents [7,[42][43][44], engagement with youth advocates [7,45], supporting data, and other localities previously enacting the policy influenced adoption [42]. Past studies also suggest that the absence of supporting data may have hampered states which attempted to adopt T21 early [6,7], but in later years, the IOM report proved powerful enough to elevate the attention of T21 as a tool to reduce youth tobacco use. ...

Evaluating Local Policy Adoption Campaigns in California: Tobacco Retail License (TRL) Adoption
  • Citing Article
  • December 2013

Journal of Community Health

... CHWs have historically served as community health liaisons, but there was an additional need during the COVID-19 pandemic for CHWs to provide critical services to refugee and immigrant communities, like providing support for case investigation and contact tracing (CICT), facilitating access to vaccines, and conducting education and outreach (7,10,11). With regard to CICT and vaccine access, refugee and immigrant communities faced overlapping challenges due to different cultural practices around health and healthcare, difficulties accessing health information and services, community concerns about vaccines and, sometimes, distrust of government or health systems (12,13). As for education and outreach, the COVID-19 pandemic challenged public health departments across the United States to develop clear messaging for diverse populations. ...

Pandemics and Vaccines: Perceptions, Reactions, and Lessons Learned from Hard-to-Reach Latinos and the H1N1 Campaign
  • Citing Article
  • August 2012

Journal of Health Care for the Poor and Underserved